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Home My WebLink About20576-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20843 Date JULY 9~ 1992 THIS CERTIFIES that the building Location of Property 1105 PARKVIEWLia_NE House No. Street County Tax Map No. 1000 Section 15 Block 5 subdivision Filed Map No. ADDITION ORIENT~ N.Y. Hamlet Lot 24.26 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 22~ 1992 pursuant to which Building Permit No. 20576-Z dated APRIL 23, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of 'the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A RICHARD J. & IRENE CAPUTO Rev. 1/81 ' / jding Tn:~p~ctO'r !~0~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_No, 20575Z Permission is hereby granted to: // ..... ,o .............................................. ~ ~g~ed ~.zza~ ...... ~~...~ ........................................... County Tax Map No. 1000 Section .......... .~.,,~....... Block ........ ~ ..... Lot No.....~.....~..~....?r...~> . ..~../...~. ~ · 19..~.....,~and approved by the pursuant to application dated ..... ~"7'"" ....................................... ' Building Inspector. Rev. 6/30/80 Ae I 31992 : / BU[LDIHC DBPA~TMENT TOWN OF A~PL[CATION FOR CERT[FICA?E OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buiIdings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .............. ;ew Construction ........... Old Or Pre-existing Building ......... Location of Property .......................................... House No Street .................. , Hamlet )nwer or Owners of Property ........ ' ....· ..... :ounty Tax Map No 1000, Section ........ ' .... Block ............ Lot ................. ubdivision .................. .................. Filed Map ............ Lot .... ......... Date Of Permit .... Appli ' - ........ cant ......... ealth Dept. Approval ...................... Uuderwriters .... Approval lanning Board Approval ................ equest for: Temporary Certificate ........... Final Certicate ........... ee Submitted: $ ............................. ;AP P L I CA~NT FOUNDATION ( 1 st) FOUNDATION ( 2nd ) ~ ROUGH FRAME & -PLUMBTNG [IISULATION FERN. Y. m CODE ~ ~ ...,/;. ~.' ~ ~ ADDITIO~AL COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971~ TEL.: 765-7802 Examined ., 19 .~..o~ Disapproved a/c ..................................... . ( B~Idin ~g,,l~-spc~ t or) APPLIGATION FOR BUILDING PERMIT CALL .-. ....... HAIL TO: Date ................... 19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Build/nc Inspector, with 3 zts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationsliip to adjoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. ¢. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Bdilding Inspector will issued a Building Permit to the apt~licant. Such permit mil be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy mil ,have been granted by the Building Inspector. · AP. PLICATION. IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the s ~t alterations, or for removal or demolition, as herein described. ne applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to (Signature of applicant~/~'~ame, if a corporation) ............................... ,.-..:..,.. (Mailing address of applicant) tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder2 ameofownerofpremises . ~.. .~. ~'~I-/ T O /"~/~.././,z") /'~ Z3 ,,7'" c/- ...~',~ ~'d,/~-' (as on the t~ roll or latest deed) 'applicant is a corporation, signature of duly authorized officer. (Name and title of Corporate officer) Builder's License No....z/.47.:...~..~...~..*~...Z... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Loc ti ?fl d hi h p k ill b d'~' a on an on w c reposed wor w e ne ................ ~ ...... ............... //o ...................... 0 llouse Number Street Hamlet County Tax Map No. 1000 Seclion ... Subdivision ..................................... Filed Map No. (Name) .............. Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~{~ ~/D~Z ' nten e use an occupancy ..................... property lines. Give street and block m interior or comer lot. 3. Nature of work (check which aplplicable): New Building .......... Addition ~..~..-.~./.c.... Alteration .......... Repair .............. Remdval .............. Demolition .............. Other,Work ............... 4, ~sti~ted Cost ..... ~ ..... es~:~ption) , (to be pa~d on R~in~ this ~pT~c~t on) 5. If dwelling, number of dwelling 0nits .... Nsm~e. ~ ~ ~ , ' If garage, number of cars .... j , · · · · o ~muwcumg umts on each floor ........... 6. If business, commerclal or m~xe y, specify natur nd exten leach 7. Dimensions of ex sting structure , if any: Front ............... Rear .............. Depth ............... ~eight Number of Stories Depth Front Rear Dimensions of same structure wi~h alterations or additions: Height ............................... 8 .................... ~ ....................... Ntnnber of Stories · Dimensions of entire new constn~ction: Front .............. ' ........ ............... 'Rear Depth Height ............... Num her of Stories 9. Size of lot: Front .... · ...................................... ............... Rear ...... Depth I0. Date of Purchase .... ' ................. t ........ ......................... Name of Former Owner 11. Zone or use district in which prmhises are situated ........... ' ............................ it g I di ......................................... 12. Does proposed construction viola e any zonin aw, or hence or regulation: 13. Will lot be regraded ...................... ~q ....... fp ............................ Will excess fill be removed from premises: Yes No N~e of Owner o remises .... i ................ Address ................... Phone No ................ Name of Architect ......... ' Address Phone No. N~e of Contractor .... , ................... ...................... Address ................... Phone No ................ Is thSs property wlthSn 300 ~eet of a tSdal wetland? ~Yes ....... No. ~. .. ~ · .. . ~I~ yes, Souehold wn Trustees Permit may be requSred ... ~ PLOT DIAG~I Locate clearly and distinctly ~1 bud&ngs, whether existing or proposed, and. indicate ~1 set-back d~ensions from tmber or descfiptio~ accordNg to deed, and show street nines and indicate whether ATE OF NEW YORIf~_ .............. being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) ore named. is the ' (Con tract'orl a oent ,rpora't; ...................................... i officer etc ) said owner or owners, and is duly atltborized to perform or bare performed the said work and to make and file this ~lication; that all statemcsts contained in this application are true to the best of bis knowledge and belief; and that the rk will be performed in the manner set[ fort ~ in the application filed therewith. om to before me this ~ 0 I